Nokea
The nurse is caring for an 8-year-old girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbances. They state it seems worse when she is anxious and does not occur while sleeping. The nurse questions the parents about which recent illness?
- A. Kawasaki disease (KD)
- B. Strep throat
- C. Malignant hypertension
- D. Atrial fibrillation
Correct Answer: B
Rationale: Chorea (spastic movements, facial grimacing, and speech disturbances) can be a manifestation of rheumatic fever following streptococcal pharyngitis, with a higher incidence in females.
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In a patient with painful joint swelling the following investigations are diagnostic:
- A. C-reactive protein
- B. Antinuclear antibodies
- C. Serum C3 (complement) levels
- D. Microscopic examination of synovial fluid
Correct Answer: D
Rationale: Microscopic examination of synovial fluid can reveal crystals, infection, or inflammation, providing a definitive diagnosis.
A two-year-old child should have been immunised against:
- A. Tetanus
- B. Polio
- C. Measles
- D. Hepatitis A
Correct Answer: C
Rationale: By the age of two, a child should have received the MMR vaccine, which protects against measles, mumps, and rubella.
Nurse Betina should begin screening for lead poisoning when a child reaches which age?
- A. 6 months
- B. 12 months
- C. 18 months
- D. 24 months
Correct Answer: B
Rationale: Screening for lead poisoning typically begins at 12 months, as children at this age are more likely to be exposed to lead through crawling and hand-to-mouth activities.
A client with draining skin lesions of the lower extremity is admitted with possible Methicillin-Resistant Staphylococcus Aureus (MRSA). Which nursing interventions should the nurse include in the plan of care?
- A. Institute contact precautions for staff and visitors.
- B. Send wound drainage for culture and sensitivity.
- C. Monitor the client's white blood cell count.
- D. Administer broad-spectrum antibiotics before obtaining cultures.
Correct Answer: B
Rationale: MRSA requires contact precautions to prevent spread, culture and sensitivity testing is necessary to identify the specific organism, and WBC count should be monitored to assess for infection.
The nurse is caring for a child with acute glomerulonephritis. Which of the following would most likely indicate that the child’s condition is improving?
- A. Increased urine output with normal color and consistency
- B. Decrease in the blood pressure
- C. A reduction in protein levels in the urine
- D. A decrease in hematuria
Correct Answer: A
Rationale: Improved renal function is indicated by increased urine output and the return of urine to normal color and consistency.